(425) 354-3628
Jessica H. Y. Chen DDS &
Emma K. Etemadi DDS
14142 Main Street NE
Suite 104
Duvall, WA 98019

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Article From Runner's World: 5 Ways Runners Are Messing Up Their Teeth

May 19th, 2017

5 Ways Runners Are Messing Up Their Teeth

Dentists know that endurance training can cause some problems inside your mouth.

By Cindy Kuzma MONDAY, MAY 15, 2017, 3:34 PM

It might be obvious to your dentist that you’re a runner from the moment you slide into the chair. Those trainers and the Garmin are dead giveaways.

But if it’s not at first glance, the dentist might be able to tell as soon as you open your mouth.

In fact, a small study of triathletes published in The Scandinavian Journal of Medicine & Science in Sports found higher rates of erosion and cavities with heavier endurance training.

Here’s what dentists might be seeing on runners’ teeth—and what those professionals wish runners would do to take care of them.

1. Overdoing it on sugar in the name of fueling.

The gels, chews, and sports drinks that fuel your workout also feed bacteria that occur naturally in your mouth, says Jeremy Hoffman, D.D.S., a dentist and runner who works at two practices in Wisconsin (one in Weston and one, appropriately enough, in Marathon City). As these bugs dine, they produce an acid that eats away at the protective enamel covering your teeth.

To your dentist, this decay looks like white, chalky lines, he says. If you constantly swill sports drinks, it might appear at the base of your teeth where they meet the gums. Or, it might show up where liquid splashes over your front teeth, otherwise an uncommon area for cavities, says Bridget Lyons, D.M.D., an Atlanta-based dentist who competed in the 2016 U.S. Olympic Marathon Trials. Turner had an ultrarunner patient who put energy blocks in her cheek and let them dissolve during training and races; she arrived for her appointment with multiple small cavities between her teeth.

The fix: Regardless of your sugar delivery method, you can protect your teeth by swishing your mouth out with water immediately after you ingest it, says Julia Burchett, D.D.S., a dentist and marathoner in Eldersburg, Maryland. A healthy diet and plenty of non-sugary beverages during the rest of your day can also give your mouth a respite, reducing your cavity risk, Hoffman says.

If you’re cavity-prone, consider using gels with a thinner consistency that don’t stick to your teeth, he says. And seek out flavors without citric or tartaric acid—these compounds, which give sour or tart foods their flavor, can further erode your enamel with frequent or extended use.

2. Forgetting what it means that you’re a mouth breather.

Many runners are mouth-breathers, a habit that can leave you a bit dried out. Less spit means more cavities, Hoffman says, because saliva washes away debris and also neutralizes acids from food and bacteria.

During high-intensity training, the composition and consistency of your saliva changes. “Instead of being more fluid and lubricating for your mouth, it’s more sticky and mucous-like,” Turner says. In this state, it can trap decay-causing sugars and acids instead of rinsing them away.

The fix: Again, drinking water—or just rinsing with it—can rehydrate your whole body and restore your balance. Chewing sugar-free gum sweetened with xylitol, a naturally occurring sugar alcohol, can also help, Turner says. While she chews it on the run, you don’t have to; four to five pieces anytime throughout the day can prevent plaque from building up on your teeth, she says.

3. Breaking the work you’ve already had done.

Sticky chews and dense protein bars can damage crowns and fillings. After all, the cement that holds these structures in place is weaker than your natural tooth and bone, Hoffman says. That means it’s far easier for gooey or hard foods to compromise them.

The fix: If you have had extensive dental work, exercise extra caution when chewing on sticky or crunchy foods, Lyons recommends. Or experiment with real foods to fuel your workouts, such as bananas or peanut butter energy bites.

4. Using your teeth to open up packets.

This one is self-explanatory, and yes, Lyons has seen patients chip their teeth in this way.

The fix: Just don’t tempt fate, regardless of your dental history. You’re asking for trouble.

5. Grinding at night and during workouts.

Type-A runners often clench their jaws or grind their teeth, especially at night or during tough speed sessions. While some companies sell athletic mouth guards, Burchett says she’s never seen anyone wear one to the track.

The fix: “One thing that is helpful is to concentrate on relaxing your face, relaxing your shoulders, relaxing your arms so you’re not so tense,” Lyons says. “If you can get back to that relaxed place in the workout, then I think that helps your teeth and also helps you run faster.”

If you do grind at night—symptoms include pain and stiffness when you wake up and flattened, loose teeth—talk to your dentist. Wearing a night guard can help you sleep better, always an advantage for runners. You’ll wake up refreshed and with less wear and tear on your molars and canines, Turner says.

Contact Drs. Jessica Chen and Emma Etemadi at Duvall Family Dental for your dental check up! We are your dental home in Duvall!

The Beautiful Smile You've Always Wanted

April 13th, 2017

At Duvall Family Dental  Dr. Emma Etemadi and Dr. Jessica H.Y. Chen are qualified and experienced providers of adult cosmetic dentistry. Schedule a personal consultation today to assess your smile needs and see all that is possible to give you the smile of your dreams.

What are some of the options available to you achieve the smile of your dreams?

COSMETIC BONDING

Bonding is a conservative way to repair slightly chipped, discolored, or crooked teeth. It can also be used to close spaces and empty black triangles of space between teeth. During dental bonding, a white filling is placed onto your tooth to improve its appearance. The filling “bonds” with your teeth, and because it comes in a variety of tooth-colored shades, it closely matches the appearance of your natural teeth.

Tooth bonding can also be used for teeth fillings instead of amalgam (silver) fillings. Many patients prefer bonded fillings because the white color is much less noticeable than the silver amalgam fillings. Bonding fillings can be used on front and back teeth depending on the location and extent of tooth decay.

Bonding is less expensive than other cosmetic treatments and usually can be completed in one visit to our office. However, bonding can stain and is easier to break than other cosmetic treatments such as porcelain veneers.

ADULT ORTHODONTICS

Consider Invisalign clear aligners to get the beautiful straight teeth you've always wanted — without the hardware and visible metal of braces. A consultation with our certified Invisalign providers can determine if Invisalign is right for you.

What is Invisalign?

Invisalign uses a series of invisible, removable, and comfortable aligners that no one can tell you're wearing. So, you can smile more during treatment as well as after. Invisalign is made with 3D computer imaging technology and has been proven effective.

Why Invisalign?

Not only are the aligners invisible, they are removable, so you can eat and drink what you want while in treatment. Plus, brushing and flossing are no problem. They are also comfortable, with no metal to cause mouth abrasions during treatment. And no metal and wires usually means you spend less time in your dentist's office getting adjustments. Invisalign also allows you to view your own virtual treatment plan when you start so you can see how your straight teeth will look when your treatment is complete.

How does it work?

You wear each set of aligners for about two weeks, removing them only to eat, drink, brush, and floss. As you replace each aligner with the next in the series, your teeth will move — little by little, week by week — until they have straightened to the final position your doctor has prescribed. You'll visit our practice about once every six weeks to ensure that your treatment is progressing as planned. Total treatment time averages 9-15 months and the average number of aligners worn during treatment is between 18 and 30, but both will vary from case to case.

VENEERS


Porcelain veneers are thin pieces of porcelain used to recreate the natural look of teeth, while also providing strength and resilience comparable to natural tooth enamel. It is often the material of choice for those looking to make slight position alterations, or to change tooth shape, size, and/or color.

VENEER CONSULTATION

Visiting your dentist and asking about veneers is the first step in determining if veneers are the right option for you, or if there are alternate solutions available. Communication with your dentist about what you want corrected is critical for a successful result. Spend time clearly identifying what cosmetic improvements you want to accomplish.

You’ll often hear people say that celebrities have veneers and this may seem like the best way to replicate picture-perfect teeth, but each mouth is different and veneers need to be carefully researched.

Your dentist will most likely begin with  photographs and a smile analysis to determine what steps are necessary to achieve the smile you desire. In addition, your dentist may create a diagnostic mock-up that will allow you to  visualize or virtually “try on” veneers and to see if the final result is actually what you’re looking for.

Deciding that porcelain veneers will create the look you want is only one step in the process. There is much more to learn before proceeding further.

THE HOWS AND WHYS OF PORCELAIN VENEERS

Porcelain laminate veneers consist of a compilation of several thin ceramic layers which replace original tooth enamel, and an adhesive layer. To apply a veneer, a very small amount of the original tooth enamel must be removed, usually less than a millimeter. This is essential as it creates room for the porcelain veneer to fit within the mouth and most accurately restore natural tooth function while creating an even better appearance than the original tooth.

The bond between original tooth and porcelain veneer is critical as it not only provides the esthetic perfection desired, but also a strong bond which is essential for correct veneer function. Light-sensitive resin is placed between the original tooth and the veneer and then hardened using a special curing light.

Porcelain veneers are a very successful option in many situations where the original tooth has developed poor color, shape, and contours. It is also a good choice for fractured teeth, gaps between teeth, and in some situations where the tooth position is compromised and there are minor bite-related problems. For some people, superficial stains do not respond well to tooth whitening or bleaching. In these situations, a porcelain veneer may be the best option.

CROWNS


Crowns are a cosmetic restoration used to strengthen a tooth or improve its shape. Crowns are most often used for teeth that are broken, worn, or partially destroyed by tooth decay.

Crowns are "cemented"  with a dental adhesive or chemically bonded onto an existing tooth and fully cover the portion of your tooth above the gum line. In effect, the crown becomes your tooth's new outer surface. Crowns can be made of porcelain, ceramic, metal, zirconia or a combination of materials.  Ceramic crowns are most often preferred because they mimic the translucency of natural teeth and are very strong.

Crowns or onlays (partial crowns) are needed when there is insufficient tooth strength remaining to hold a filling. Unlike fillings which apply the restorative material directly into your mouth, a crown is fabricated away from your mouth. Your crown is created in a lab from your unique tooth impression which allows a dental laboratory technician to examine all aspects of your bite and jaw movements. Your crown is then sculpted just for you so that your bite and jaw movements function normally once the crown is placed.

IMPLANTS


People are living longer than ever, and while regular brushing, flossing, and checkups allow many of us to maintain our natural smiles for a lifetime, sometimes our teeth just can't keep up. If you've lost a tooth (or a few teeth) due to injury or disease, dental implants can rejuvenate both your smile and your oral health.

An implant is a synthetic tooth root in the shape of a post that is surgically placed into the jawbone by a specialist such as an Oral Surgeon or Periodontist. The “root” is usually made of titanium: the same material used in many replacement hips and knees, and a metal that is well-suited to pairing with human bone. A replacement tooth is then fixed to the post. The tooth can be either permanently attached or removable. This tooth is fabricated by the general dentist. Permanent teeth are more stable and feel more like natural teeth.

The ideal candidate for implants is a non-smoker who has good oral health, including a sufficient amount of bone in the jaw, and healthy gums with no sign of gum disease.

Implants are versatile.

If you are only missing one tooth, one implant plus one replacement tooth will do the trick. If you are missing several teeth in a row, a few strategically placed implants can support a permanent bridge (a set of replacement teeth). Similarly, if you have lost all of your teeth, a full bridge or full denture can be permanently fixed in your mouth with a strategic number of implants.

Advantages Over Dentures or Bridges

Conventional bridges and dentures are not fixed to the bone, and can therefore be unstable. This can make it difficult to eat or smile with confidence. Implants not only look more natural, but feel and act more like normal teeth, with a stronger biting force. And because they don't directly rely on neighboring teeth for support, implants don't compromise the health of your natural teeth. In fact, bridges are only expected to last seven to ten years, even less with root canals, whereas implants will typically last a lifetime.

Schedule your smile analysis today: 425-354-3628

The Benefits of Topical Fluoride

March 27th, 2017

Fluoride is a mineral that occurs naturally in many foods and water. Every day, minerals are added to and lost from a tooth's enamel layer through two processes, demineralization and remineralization. Minerals are lost (demineralization) from a tooth's enamel layer when acids -- formed from plaque bacteria and sugars in the mouth -- attack the enamel. Minerals such as fluoride, calcium, and phosphate are redeposited (remineralization) to the enamel layer from the foods and waters consumed. Too much demineralization without enough remineralization to repair the enamel layer leads to tooth decay.

Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. It also reverses early decay. In children under 6 years of age, fluoride becomes incorporated into the development of permanent teeth, making it difficult for acids to demineralize the teeth. Fluoride also helps speed remineralization as well as disrupts acid production in already erupted teeth of both children and adults.

In What Forms Is Fluoride Available?

As mentioned, fluoride is found in foods and in water. It can also be directly applied to the teeth through fluoridated toothpastes and mouth rinses. Mouth rinses containing fluoride in lower strengths are available over-the-counter; stronger concentrations require a doctor's prescription.

At Duvall Family Dental, our Dental Assistants and Hygienists can also apply fluoride to the teeth as a gel, foam, or varnish. These treatments contain a much higher level of fluoride than the amount found in toothpastes and mouth rinses. Varnishes are painted on the teeth; foams are put into a mouth guard, which is applied to the teeth for one to four minutes; gels can be painted on or applied via a mouth guard.

Fluoride supplements are also available as liquids and tablets and must be prescribed by your dentist, pediatrician, or family doctor.

When Is Fluoride Intake Most Critical?

It is certainly important for infants and children between the ages of 6 months and 16 years to be exposed to fluoride. This is the timeframe during which the primary and permanent teeth come in. However, adults benefit from fluoride, too. New research indicates that topical fluoride -- from toothpastes, mouth rinses, and fluoride treatments -- are as important in fighting tooth decay as in strengthening developing teeth.

In addition, people with certain conditions may be at increased risk of tooth decay and would therefore benefit from additional fluoride treatment. They include people with:

Dry mouth conditions : Also called xerostomia, dry mouth caused by diseases such as Sjögren's syndrome, certain medications (such as allergy medications, antihistamines, antianxiety drugs, and high blood pressure drugs), and head and neck radiation treatment makes someone more prone to tooth decay. The lack of saliva makes it harder for food particles to be washed away and acids to be neutralized.

Gum disease : Gum disease, also called periodontitis, can expose more of your tooth and tooth roots to bacteria increasing the chance of tooth decay. Gingivitis is an early stage of periodontitis.

History of frequent cavities: If you have one cavity every year or every other year, you might benefit from additional fluoride.

Presence of crowns and/or bridges or braces: These treatments can put teeth at risk for decay at the point where the crown meets the underlying tooth structure or around the brackets of orthodontic appliances.

Are There Risks Associated With Fluoride Use?

Fluoride is safe and effective when used as directed but can be hazardous at high doses (the "toxic" dosage level varies based on an individual's weight). For this reason, it's important for parents to carefully supervise their children's use of fluoride-containing products and to keep fluoride products out of reach of children, especially children under the age of 6.

In addition, excess fluoride can cause defects in the tooth's enamel that range from barely noticeable white specks or streaks to cosmetically objectionable brown discoloration. These defects are known as fluorosis and occur when the teeth are forming -- usually in children younger than 6 years. Fluorosis, when it occurs, is usually associated with naturally occurring fluoride, such as that found in well water. If you use well water and are uncertain about the mineral (especially fluoride) content, a water sample should be tested. Although tooth staining from fluorosis cannot be removed with normal hygiene, your dentist or hygienist may be able to lighten or remove these stains with professional-strength abrasives or bleaches.

Keep in mind, however, that it's very difficult to reach hazardous levels given the low levels of fluoride in home-based fluoride-containing products. Nonetheless, if you do have concerns or questions about the amount of fluoride you or your child may be receiving, talk to your child's dentist, pediatrician, or family doctor.

A few useful reminders about fluoride include:

-Store fluoride supplements away from young children.

-Avoid flavored toothpastes because these tend to encourage toothpaste to be swallowed.

-Use only a pea-sized amount of fluoridated toothpaste on a child's toothbrush.

-Be cautious about using fluoridated toothpaste in children younger than age 6. Children younger than 6 years of age are more likely to swallow toothpaste instead of spitting it out.

I Drink Bottled Water, Am I Missing Out on the Benefits of Fluoride?

Even though there are no scientific studies to suggest that people who drink bottled water are at increased risk of tooth decay, the American Dental Association (ADA) says that such people could be missing out on the decay-preventing effects of optimally fluoridated water available from their community water source. The ADA adds that most bottled waters do not contain optimal levels of fluoride, which is 0.7 to 1.2 parts per million (this is the amount that is in public water supplies, in the communities that have fluoridated water). To find out if your brand of bottled water contains any fluoride, check the label on the bottle or contact the bottle water manufacturer.

Does a Home Water Treatment System Affect the Level of Fluoride in My Drinking Water?

The amount of fluoride you receive in your drinking water depends on the type of home water treatment system used. Steam distillation systems remove 100% of fluoride content. Reverse osmosis systems remove between 65% and 95% of the fluoride. On the other hand, water softeners and charcoal/carbon filters generally do not remove fluoride. One exception: some activated carbon filters contain activated alumina that may remove over 80% of the fluoride.

If you use a home water treatment system, have your water tested at least annually to establish the fluoride level your family is receiving in the treated water. Testing is available through local and state public health departments as well as private laboratories. Also, check with the manufacturer of the product you purchased or read the information that came with the water treatment system to determine the product's effects on fluoride in your home water.

Ask Dr. Emma Etemadi or Dr. Jessica H.Y. Chen if your teeth can benefit from the appliation of topical fluoride

Duvall Family Dental

425-354-3628

Sugary Drinks and Your Smile

March 8th, 2017

Sweetened beverages have become a treat that many Americans have every day. The truth is that these drinks are not healthy, especially for our dental health and smiles. Everyone has harmful bacteria in their mouths that eat the sugars we consume. The bacteria get energy from the sugar, but in the process produce acid. The acid they make can damage teeth, causing cavities to form or erosion to occur.

Some of the most common beverages that Americans drink actually have loads of sugar, even drinks that are marketed as “healthy” or “all natural”. If you think you’re safe with drinks like juice, think again! A glass of apple juice can contain a similar amount of sugar to glass of soda. According to the USDA, sugar should make up no more than 10% of your daily calories. For women, that is 10-15 tsp. per day. For men, it’s 12.5-18.75 tsp. Just one glass of that apple juice would put many people at (or just under) their entire daily limit.

Eliminating sugary beverages from our diets would be best, but reducing the number of sugary beverages you consume and substituting healthier options with less sugar is already a step in the right direction. Here is a list of drinks that are full of sugar and drinks that are better choices. 

Lots of Sugar Better Choices
Soda Water
Energy drinks Unsweetened tea
Chocolate milk Milk
Smoothies Plain sparkling water
Fruit punch or juice Diluted juice

All of the drinks in the better choice column have little or no sugar. That means they won’t give the bacteria in your mouth a chance to cause trouble and make acid that can damage your teeth. Water can also contain fluoride, which protects teeth against cavities. The calcium in milk also helps keep your teeth strong. If you or your children are allergic to cow’s milk, try unsweetened milk substitute (such as almond, soy, rice) with added calcium.

If you find you can’t resist your morning cup of sweetened coffee, tea, or juice, there still are some things you can do to help protect your teeth. Here are some suggestions to consider.

  • Drink, don’t sip. Sipping gives the bacteria more time to eat the sugar and to create cavities. Drink quickly to give your body time to wash away the bad stuff. Try to drink sweetened coffees, teas or sodas in one sitting instead of sipping on them over a longer amount of time. If you give your child juice, have them drink it with meals only, and put only water in a sippy cup they might carry around during the day.
  • Fluoride is your friend. If your community’s water is fluoridated, drink tap water to improve your dental health. Fluoride protects teeth and has re-duced the number of cavities across the nation.
  • Brush and clean between your teeth. Brush your teeth twice a day and clean between your teeth once a day. Ask your dentist about the best way to do this. Help all kids under the age of eight to brush and floss well, and be sure to visit to your dentist regularly.

Knowing what drinks contain sugar and that sugar-sweetened drinks can hurt your dental health is a good start. Set some goals for your family to follow these tips. Good habits begin at a young age, so help your kids make healthy decisions about what they choose to drink. Set a positive example, and you will all have healthier smiles and a healthier future.

Dr. Emma Etemadi and Dr. Jessica H.Y. Chen


Adapted from the American Dental Association

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